scholarly journals A Patient of Using Presepsin to Diagnose Streptococcal Toxic Shock Syndrome during Anticancer Drug Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Gaku Takahashi
Keyword(s):  
Blood Culture ◽  
Toxic Shock Syndrome ◽  
Lower Leg ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Anticancer Chemotherapy ◽  
Successful Recovery ◽  
Short Period ◽  
Infection Focus

Background. Streptococcal toxic shock syndrome (STSS) is a rapidly progressive infection, with potentially rapid patient deterioration in a very short period. We experienced a rare case of STSS during anticancer chemotherapy, and we continuously measured presepsin (P-SEP) and evaluated its usefulness. Case Presentation. A 60-year-old woman with pulmonary metastasis from cervical cancer began anticancer chemotherapy. A fever of >40°C and right lower leg swelling developed on day 3. Symptoms worsened despite cefmetazole treatment (1.0 g/day). Blood culture was performed without suspecting STSS. On day 5, symptoms worsened and acute disseminated intravascular coagulation (DIC) and sequential organ failure assessment (SOFA) scores increased. C-reactive protein (CRP) increased from 28.8 mg/dl to 35.5 mg/dl and P-SEP also increased from 1,635 to 2,350 pg/mL. STSS was suspected due to the rapid progression of brown discoloration of the entire right lower leg. Ceftriaxone 2 g/day and clindamycin 1,200 mg/day were begun. On the evening of day 5, blood culture revealed rapidly progressive group A streptococci. After that, symptoms improved rapidly with treatment, and SOFA and DIC scores also decreased. While CRP remained at about 0.5 mg/dl, P-SEP remained slightly elevated at about 400 pg/mL. A residual infection focus was suspected. Contrast-enhanced computed tomography (CT) revealed a capsule-enclosed abscess in the right lower leg soleus muscle on day 32. Debridement was performed and antibiotics were continued until P-SEP was 88 pg/mL. CT confirmed the disappearance of the abscess. Conclusion. Prompt diagnosis by blood culture and a sufficiently early, appropriate change in antibiotic therapy led to successful recovery from STSS during anticancer chemotherapy without lower limb amputation. P-SEP was useful in assessment of the residual infection focus and suspending treatments.

scholarly journals „Tempus fugit, venit mors” – a streptococcalis toxikus sokk szindrómáról egy eset kapcsán

2019 ◽  
Vol 160 (48) ◽  
pp. 1887-1893
Author(s):  
Bálint Gergely Szabó ◽  
Rebeka Kiss ◽  
Katalin Szidónia Lénárt ◽  
Nikolova Radka ◽  
Béla Kádár
Keyword(s):  
Toxic Shock Syndrome ◽  
Signs And Symptoms ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Life Threatening Illness ◽  
Life Threatening ◽  
Group A ◽  
High Level ◽  
Portal Of Entry

Abstract: Streptococcal toxic shock syndrome (STSS) is a hyperacute, life-threatening illness, a complication of invasive streptococcal (mostly group A, rarely groups B, G or C) infection. There is no portal of entry (skin, vagina, pharynx) in nearly half of the STSS cases. The initial signs and symptoms (fever, flu-like complaints, hypotension) are scarce and aspecific, but because of its rapid progression and poor prognosis, early high level of suspicion is necessary. Management has 3 crucial points: initiation of anti-streptococcal regimen (and intravenous immunoglobulin in some cases), aggressive intensive care support of multi-organ failure, and surgical control of the infective source. In this article, we present a case of a patient succumbing to streptococcal toxic shock syndrome which was preceded by primary S. pyogenes bacteremia, and review the key points of this potentially fatal disease for practising clinicians. Orv Hetil. 2019; 160(48): 1887–1893.

scholarly journals Group a streptococcal cellulitis in the early puerperium

2011 ◽  
Vol 68 (7) ◽  
pp. 607-610
Author(s):  
Branka Nikolic ◽  
Ana Mitrovic ◽  
Svetlana Dragojevic-Dikic ◽  
Snezana Rakic ◽  
Zlatica Cakic ◽  
...  
Keyword(s):  
Case Report ◽  
Toxic Shock Syndrome ◽  
Early Recognition ◽  
Healthy Woman ◽  
Supportive Therapy ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Short Period ◽  
History Of ◽  
Group A

Introduction. Infectious diseases caused by Streptococcus pyogenes, a member of the group A Streptococci (GAS) are among the most common life threatening ones. Patients with GAS infections have a poor survival rate. Cellulitis is a severe invasive GAS infection and the most common clinical presentation of the disease associated with more deaths than it can be seen in other GAS infections. According to the literature data, most cases of GAS toxic shock syndrome are developed in the puerperium. However, there are two main problems with GAS infection in early puerperium and this case report is aimed at reminding on them. The first problem is an absence of awareness that it can be postpartal invasive GAS infection before the microbiology laboratory confirms it, and the second one is that we have little knowledge about GAS infection, in general. Case report. A 32- year-old healthy woman, gravida 1, para 1, was hospitalized three days after vaginal delivery with a 38-hour history of fever, pain in the left leg (under the knee), and head injury after short period of conscious lost. Clinical picture of GAS infection was cellulites. Group A Streptoccocus pyogenes was isolated in vaginal culture. Rapid antibiotic and supportive treatment stopped development of streptococcal toxic shock syndrome (STSS) and potential multiorganic failure. Signs and symptoms of the infection lasted 25 days, and complete recovery of the patient almost 50 days. Conclusion. In all women in childbed with a history of fever early after delivery, vaginal and cervical culture specimens should be taken as soon as possible. Early recognition of GAS infection in early puerperium and prompt initiation of antimicrobial drug and supportive therapy can prevent development of STSS and lethal outcome.

scholarly journals Streptococcal necrotizing fasciitis with toxic shock syndrome and rapid fatal outcome

2015 ◽  
Vol 143 (7-8) ◽  
pp. 476-479 ◽  
Author(s):  
Miroslav Kojic ◽  
Dragan Mikic ◽  
Darko Nozic ◽  
Bojan Rakonjac
Keyword(s):  
Necrotizing Fasciitis ◽  
Toxic Shock Syndrome ◽  
Rapid Development ◽  
Fatal Outcome ◽  
Lower Leg ◽  
Multiple Organ ◽  
Deep Fascia ◽  
Rapid Progression ◽  
Toxic Shock ◽  
Serious Disease

Introduction. Streptococcal necrotizing fasciitis (NF) is a serious soft tissue infection with rapid progression of inflammatory process among superficial or deep fascia, systemic host response to infection leading to toxic shock syndrome (TSS), and multiple organ failure. Lethality is high. Case Outline. A 46-year-old male without co-morbidities was admitted to the Emergency Department with redness, swelling and pain on his right lower leg. He became sick two day s ea rlier with m alaise, chills and shivering. On admission he was hypotensive, anuric, with erythematous rash on his face, neck and chest, with acute ren al failure and elevated creatine phosphokinase level. During the next several hours, the changes on his right lower leg rapidly spread to the whole leg, followed by skin destruction and subcutaneo us bleeding, indicating NF. Aggressive antimicrobial, supportive and symptom atic therapy was initiated immediately and on the same evening surgical intervention was performed. Despite these measures, a rapid development of severe TSS, with lethal outcome, occurred in less than 40 hours after the admission. Stre ptococcus pyogenes (group A ?-hemolytic Streptococcus) was isolated from the throat, skin and tissue obtained duri ng the surgery. Conclusion. Necrotizing fasciitis is a very serious disease with unpre dictable course. For that reason doctors must devote a great deal of a ttention to early, i.e. timely diagnosis of this disease, whose treatment with a multid isciplinary approach is very important.

Streptococcal Toxic Shock Syndrome in the Emergency Department

2020 ◽  
Vol 15 (02) ◽  
pp. 091-094
Author(s):  
Carmina Guitart-Pardellans ◽  
Vanessa Arias Constanti ◽  
Victoria Trenchs Sainz de la Maza ◽  
Nuria Elvira Sanz Marcos ◽  
Iolanda Jordan García ◽  
...  
Keyword(s):  
Emergency Department ◽  
Toxic Shock Syndrome ◽  
Early Stage ◽  
Clinical Manifestations ◽  
Pediatric Intensive Care ◽  
Complete Recovery ◽  
Final Diagnosis ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock

Abstract Objective Streptococcal toxic shock syndrome (STSS) is a very rare and severe entity from among the invasive diseases caused by Streptococcus pyogenes, whose characteristics, treatment, morbidity, and mortality are little known in pediatrics. The aim of this study was to determine its prevalence and the characteristics of its presentation in the emergency department (ED) in Spain. Methods This is a descriptive and observational study. Patients from 1 month to 18 years of age, admitted to the ED with a final diagnosis of STSS between 2009 and 2014, were included. Patients whose parents or guardians did not allow informed consent were excluded. Results Nine cases were diagnosed (1/100,000 consultations); the median average age was 2 years, and five were girls. No patient had a significant medical history. The most frequent reason for consultation was fever (9/9), followed by respiratory symptoms (6/9). Six presented in the ED with shock. Seven were diagnosed with pleuropneumonia, one with meningitis, and one with necrotizing fasciitis. All patients required admission at the pediatric intensive care unit, mechanical ventilation, and inotropic support. All had a complete recovery. Conclusion STSS is a rare entity in the ED affecting healthy patients who presented respiratory or otorhinolaryngology disease. In our patients, nonspecific clinical manifestations and its rapid progression to shock are shown, meaning the importance of bearing this entity in mind in the emergency room. Understanding the epidemiology and clinical manifestations of this syndrome in our work area helps pediatricians to recognize it and to initiate the appropriate treatment at an early stage, which helps engender a quick and effective approach, essential for a favorable prognosis.

scholarly journals A Fatal Case of Streptococcal Toxic Shock Syndrome Caused By Genotype Emm1 In The Third Trimester of Pregnancy, China

2021 ◽  
Author(s):  
Yasha Luo ◽  
Minling Zheng ◽  
Yanyuan Chen ◽  
Chunming Gu ◽  
Lijuan Lv ◽  
...  
Keyword(s):  
Clinical Picture ◽  
Toxic Shock Syndrome ◽  
Fatal Case ◽  
Invasive Disease ◽  
Fetal Mortality ◽  
Rapid Progression ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Third Trimester ◽  
The Third

Abstract Background: Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare invasive disease, causing a high risk of maternal and fetal mortality during pregnancy. We report a fatal case of a female caused by GAS-TSS in the third trimester of pregnancy in Guangzhou, China. Case presentation: The patient is a 33-year-old female who presented at 37 weeks’ gestation with a history of three hours fever. The patient underwent an early onset and rapid progression with dramatic clinical picture and laboratory characters within 24 hours. The neonate survived after an aggressive anti-infection treatment.The GAS strains were isolated from two bottles of blood cultures and airway secretion culture, which confirmed as Streptococcus pyogenes associated with genotype emm1 by molecular analysis.Conclusion: Dramatic clinical picture and laboratory characters of the pregnant woman presented here might help improve clinicians' awareness and recognition of Streptococcus pyogenes, which could be of great importance for the early diagnosis of GAS- TSS in pregnancy.

Streptococcal toxic shock syndrome revealed phlegmasia cerulea dolens of the arm

2020 ◽  
Vol 20 (11) ◽  
pp. 1348
Author(s):  
Vivien Moris ◽  
David Guillier ◽  
Narcisse Zwetyenga ◽  
Eric Steinmetz
Keyword(s):  
Toxic Shock Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Phlegmasia Cerulea Dolens

scholarly journals Streptococcal toxic shock syndrome following total thyroidectomy

2013 ◽  
Vol 95 (7) ◽  
pp. 457-460 ◽  
Author(s):  
J AZ Hung ◽  
P Rajeev
Keyword(s):  
Total Thyroidectomy ◽  
Toxic Shock Syndrome ◽  
Cowden Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Rare Occurrence ◽  
Toxic Shock ◽  
Group A ◽  
High Index Of Suspicion ◽  
Improve Patient ◽  
Management Issues

Group A streptococcal toxic shock syndrome following clean surgery is a rare occurrence. Its incidence following thyroid surgery has not been described in the literature. We report on the presentation and management of severe streptococcal toxic shock syndrome following a total thyroidectomy for a multinodular goitre in a patient with Cowden syndrome. This report presents an overview of streptococcal toxic shock syndrome with a focus on the management issues to consider so as to improve patient outcome. All surgeons must maintain a high index of suspicion for this rare but dangerous entity.

scholarly journals Capsule ofStreptococcus pyogenesIs Essential for Delayed Death of Mice in a Model of Streptococcal Toxic Shock Syndrome

2006 ◽  
Vol 50 (2) ◽  
pp. 127-130 ◽  
Author(s):  
Ken-ichiro Iida ◽  
Masanori Seki ◽  
Mitsumasa Saito ◽  
Yoshiaki Kawamura ◽  
Hideko Kajiwara ◽  
...  
Keyword(s):  
Toxic Shock Syndrome ◽  
Streptococcal Toxic Shock Syndrome ◽  
Toxic Shock ◽  
Delayed Death
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